Primary Treatment of Acute Retinal Necrosis with Oral Antiviral Therapy

Geoffrey G. Emerson, Justine R. Smith, David Wilson, James (Jim) Rosenbaum, Christina Flaxel

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Purpose: To explore the possibility of oral antiviral therapy in lieu of intravenous acyclovir for treating acute retinal necrosis (ARN), a necrotizing retinopathy caused by herpes simplex virus type 1 or 2 or by varicella zoster virus. Design: Retrospective, interventional, small case series. Participants: Four patients (6 eyes). Methods: Patients were treated with oral antiviral therapy. Medications included valacyclovir (1 g 3 times daily), oral famciclovir (500 mg 3 times daily), and topical and oral corticosteroids. Main Outcome Measures: Improvement of symptoms, including photophobia, blurred vision, ocular discomfort, and floaters; increase in visual acuity; and resolution of vitreitis, retinitis, and retinal vasculitis, where present. Results: Symptoms and visual acuity improved within 2 weeks to 1 month in 3 of 4 patients (75%) treated with oral antiviral medication. One patient required surgical treatment for asymptomatic retinal detachment after 3 weeks of treatment; retinal detachment in the fellow eye was repaired 2 months later. Duration of antiviral therapy ranged from 5 weeks to 3 months. Conclusions: For 4 patients with relatively indolent cases of ARN, oral antiviral therapy alone was effective in eliminating signs and symptoms of the disease. In particular, oral valacyclovir and famciclovir appeared to be effective, although further study is necessary to determine whether these drugs are as effective as intravenous acyclovir for initial treatment of ARN.

Original languageEnglish (US)
Pages (from-to)2259-2261
Number of pages3
JournalOphthalmology
Volume113
Issue number12
DOIs
StatePublished - Dec 2006

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Acute Retinal Necrosis Syndrome
Antiviral Agents
valacyclovir
Acyclovir
Retinal Detachment
Therapeutics
Visual Acuity
Retinal Vasculitis
Retinitis
Photophobia
Human Herpesvirus 3
Human Herpesvirus 2
Human Herpesvirus 1
Signs and Symptoms
Adrenal Cortex Hormones
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Primary Treatment of Acute Retinal Necrosis with Oral Antiviral Therapy. / Emerson, Geoffrey G.; Smith, Justine R.; Wilson, David; Rosenbaum, James (Jim); Flaxel, Christina.

In: Ophthalmology, Vol. 113, No. 12, 12.2006, p. 2259-2261.

Research output: Contribution to journalArticle

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